Full Text Article. Also available at https://www.ajol.info/index.php/ssmj/article/view/192915Introduction: Female Genital Mutilation (FGM) is widespread in Tanzania and poses a risk when women give birth. Objective: To determine the association between FGM and perineal injury among women in labour in Dodoma Methods: A matched case-control study of 364 randomly selected consenting women in labour was conducted in Dodoma Region between January 2017 and June 2018. Controls (no perineal injury) were matched to the cases (with perineal injury) based on maternal age at a ratio 2:1 making a sample of 243 controls and 121 cases. FGM and perineal injury was directly observed during labour using WHO guidelines. Data were analysed by using SPSS version 20 for Window (SPSS Inc., Chicago, IL, USA). Frequency tables were generated and bivariate analyses were conducted. The association between FGM and perineal injury was determined using chi-squared statistics. Results: Of the 364 women were investigated 40.4% (n=147) were circumcised and 59.6% (n=217) were not. There was a significant association between FGM and perineal injury (p=0.001). Conclusion: The FGM rate was high. FGM (total and Type II) was significantly associated with perineal injury.